Living and Dying With Dignity
By Dr. Nancy Fishman / Morgan Hill, Calif.
I am witnessing two women in battle. One is fighting for her life and the other is fighting for her death. Both want to control their destinies with dignity.
My sister, Bonnie, has been through years of painful cancer treatment. The treatment itself caused unexpected consequences for which she was unprepared. The cancer went into remission in fall 2024 but returned with a vengeance in spring 2026. At that point, she was offered the option of a stem cell transplant, which has the potential for a cure. She said, Yes! Bring it on!
My friend Jill has suffered miserably for decades with Crohn’s disease. Painful surgeries and unsuccessful treatments have left her with profound hopelessness. Following the most recent operation, the doctor informed her she would be facing additional surgeries with little chance for a positive outcome. Now in her 70s, Jill made it clear to her doctors, family and friends she did not want to continue living with such pain and compromised quality of life. She said, No! I’m done!
What these two courageous women have in common is the privilege to choose between life and death, and the right to fight for the dignity they each deserve. Jill lives in California, a state where people have the legal right to medically assisted termination of life.
Bonnie subjected herself to a stem cell transplant. It required harvesting cells from her body, a round of chemotherapy, and then the implantation of the engineered cells back into her body. This procedure wiped out her immune system. She had to move from her home and live in the hospital and an apartment close to the hospital for several weeks. She was barred from some of her favorite activities for 6 to 12 months. She has suffered physically and emotionally as she has fought for the freedom to live a healthier version of herself.
Jill, on the other hand, did not have more treatment options or a rosier future. Her latest hospitalization was the last in a long saga without a tolerable ending. Like Bonnie, she has suffered physically and emotionally. Finally facing her fate, Jill began the struggle to free herself from the bondage of illness. She informed her family and medical team that she wanted to enlist the help of hospice and have a medically supported death.
Both women were desperate to get home to their own beds, their families, their dogs. Home is the place where they both find comfort and safety. Bonnie looks forward to recuperating with dignity. Jill, with no hope for recovery, can plan a dignified exit.
It’s easy to speculate what we would do in their circumstances, but nobody can really know unless we could walk in their shoes. It is nearly impossible to stand on the outside witnessing the excruciating quandary women like Bonnie and Jill face. Friends and family often feel helpless to ease the burden of their loved ones.
As a psychologist and strategy consultant, I have helped many friends and family members of patients like Bonnie and Jill understand their role at times like this. I have suggested they ask themself two questions: What does the patient want me to do? And how can I support them in a way that serves them rather than myself?
The first way to be supportive is to really listen to what the patient wants, even if those wishes are contrary to how you feel. Like Jill, my brother-in-law, Sherwin, had been suffering from painful dialysis treatments three times a week. He saw what the future held for him and decided he did not want to live with the restrictions and poor quality of life. He announced to our family that he would be terminating dialysis, knowing that within a couple of weeks his kidneys would fail and he would not survive.
The family was alarmed by Sherwin’s announcement. His wife and grown children attempted to talk him out of the decision. They tried to get him to consider other options, but Sherwin was quite certain about his decision. At that point he needed his family’s support to face the end of his life. Without it, he would have died with a sense of loneliness.
Soon the family realized they were advocating for more dialysis because they were not ready to let go of Sherwin. When they set aside their self-serving hopes, they were able to be with Sherwin in ways he needed them during the little time he had left. Instead of being emotionally alone, he was surrounded by a loving and supportive family.
Another way to show up for a loved one in distress is to ask them directly what you can do that would be helpful. We shouldn’t assume to know what anyone needs in their situation. Many people project themselves into the scene and imagine how they would feel, but this is often not at all what the patient actually wants.
Finally, we must read the room! This is extremely necessary because it goes right to a patient’s dignity. When I go to Bonnie’s for a visit, I never know how she is feeling. Is she having a moment of relief that her treatment worked, or is she grieving the loss of time and activities she missed over the years she was doing battle with cancer? I don’t want to appear on her porch all smiles if she is underwater with sadness. If I visit Jill, I don’t want to bring doom and gloom to her if she is has made peace with her decision and hopes to have a light, easy conversation.
Most importantly, we must not attempt to control the fate of others or the choices they make for themselves. They must have the dignity to choose how they want to live or die. We can be respectful and supportive without being in front of them pulling, or behind them pushing. It’s more helpful to be next to them on the path they have chosen.
This column is devoted to psychological topics that speak to the human condition, such as relationships, family, love, loss, and happiness. The ideas, thoughts, philosophies, and observations expressed here are personal and not meant as professional advice. Names and identifying information have been changed to protect the privacy of real people.
Dr. Nancy Fishman moved to Santa Clara County in 2016 from Michigan, where she was a practicing psychologist. Currently, she is a strategy consultant to individuals, families, businesses, family law attorneys and their clients, working on coping, managing, reorganizing, pivoting and innovating. She is the founder of Forgotten Harvest, one of the nation’s largest food recovery operations. She is also the creator of Silicon Valley’s A La Carte food recovery and distribution initiative, and the organizer of Feeding Morgan Hill. Nancy lives on a family compound with her husband, sisters, brother-in-law, and a pack of dogs.
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